Individual
JACLYN MARIE BOUSQUET
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
759 CHESTNUT ST, SPRINGFIELD, MA 01199-1001
(413) 794-4180
Mailing address
39 DAY AVE, EAST LONGMEADOW, MA 01028-1938
(413) 237-9346
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
PCT.0011518
CT
183500000X
Pharmacist
Primary
PH27616
MA
Other
Enumeration date
05/10/2010
Last updated
05/10/2010
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